$5.8 Million Funds 2 New Studies on Best Treatments for ADHD

By Lois Baker

BUFFALO, N.Y. -- William E. Pelham, Jr., Ph.D., professor of psychology, pediatrics and psychiatry at the University at Buffalo and one of the leading experts in the treatment of attention deficit hyperactivity disorder (ADHD) in children, has received a total of $5.8 million to begin two new studies of treatment approaches for the condition.

The Centers for Disease Control and Prevention have estimated that approximately 4.4 million children in the U.S. between the ages of 4 and 17 have been diagnosed at some point with ADHD.

Results of both studies are expected to help teachers, physicians and families better determine the best treatment plan for each child. Pelham currently is recruiting children in Western New York and Southern Ontario to take part in the studies.

In one study, Pelham, director of the UB Center for Children and Families, will examine the effectiveness of different amounts of behavior modification for young children with ADHD who are not receiving medication at present. Treatment will begin in August and will last for three years. The study is being funded by a $3.15 million grant from the National Institute of Mental Health.

The second study will investigate the interactions of medication and behavior modification, and the effect of changes in one intervention on the other's effectiveness and on their combined effectiveness. Children in this study will be involved for one school year, and will enter the study in August 2006, 2007 or 2008. It is being funded by a $2.7 million grant from the Institute of Educational Services, U.S. Department of Education.

The three-year study will involve 150 children who will be in kindergarten or first grade in September 2006 and who meet criteria for ADHD. Because many parents do not know at this young age whether their children have ADHD, children with symptoms of distractibility, impulsivity, difficulty completing tasks and following rules can be referred and will be evaluated for ADHD, Pelham said.

The children will be assigned to one of three groups: a "community comparison group" that receives careful monitoring and medication if needed; a "standard behavior modification group," that receives a typical package of parent-training sessions, teacher-consultation sessions and social-skills sessions for the child; or "enhanced behavior modification," which involves intensive intervention for the parents, teachers and children, including the center's highly regarded Summer Treatment Program that has been conducted at UB for the past decade.

The researchers aim to evaluate whether the need for and/or dose of medication can be minimized by beginning behavioral treatment early and continuing it over the long term.

The one-year study will involve a total of 144 children aged 5-12 in the three cohorts. These children will have been diagnosed with ADHD and may be receiving medication.

This study aims to determine how a treatment strategy that includes either initial treatment with medication or initial behavior modification (parenting sessions, teacher consultation, social-skills training for the child) influences response to treatment. It also will assess the relative benefits of augmenting the initial treatment versus adding the other treatment, when additional treatment is needed.

"These studies will go a long way toward answering two important questions: Do young ADHD children need medication, and what treatment should be used first with ADHD -- medication or behavioral approaches?" said Pelham.

"These are the questions that parents, schools and doctors face every day, but there is not a lot of evidence to guide them in this critical choice," he noted. "Given growing concerns about the dramatic increases in use of medication for ADHD and its short- and long-term safety, knowing whether alternatives work just as well is key."

Parents interested in enrolling their children in either study or learning more about the studies may call the Center for Children and Families at 829-2244, ext. 5, or visit the center in 106 Diefendorf Hall on the UB South (Main Street) Campus. Additional information about ADHD for parents and teachers can be found at http://www.wings.buffalo.edu/adhd.